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There is no MMWR telebriefing scheduled for January 28, 2010.

To prevent infections in patients undergoing spinal procedures – including spinal anesthesia - healthcare providers should wear masks and follow CDC recommendations for safe injection practices. CDC collaborated with state and local public health authorities in Ohio and New York to investigate why five women developed meningitis while in the hospital following childbirth. Each of the women received spinal anesthesia for pain relief during labor. Tests confirmed that four of the women were infected with Streptococcus salivarius, a type of bacteria normally found in the mouth and throat. In both states, lapses in proper infection control were identified at the hospitals. CDC issued guidance to healthcare providers in 2007 that lists steps that should be taken when performing spinal injection procedures to minimize the occurrence of these rare but serious infections. Hospitals and other healthcare facilities should ensure that healthcare providers who perform spinal procedures are familiar with and follow these recommendations.

2. Effects of Switching from Whole to Low-Fat/Fat-Free Milk in Public Schools – New York City, 2004-2009

These results suggest that substitution of low-fat and fat-free milk for whole milk in schools can substantively reduce student consumption of calories and fat. Changes to the New York City Department of Education’s milk policy greatly reduced the amount of calories and fat available to public school students. Due to the system-wide switch from whole to low-fat/fat-free milk in 2005, a milk-drinking student is exposed to 33 fewer calories and 3.4 fewer grams of fat per school day, or almost 6,000 fewer calories and over 600 fewer grams of fat annually. Annual savings are larger for students who drink white milk (7,000 fewer calories and over 900 fewer grams of fat) and school purchases of milk per student actually increased 1.3 percent after the switch. Given the prevalence of childhood obesity, school milk policy changes are a viable way to reduce calorie/fat exposure without decreasing consumption of important vitamins and minerals.

Long-term care facilities (LTCFs) should continue implementing recommended infection control practices to prevent the spread of influenza within the facility. Health-care personnel should be vaccinated against 2009 H1N1 and seasonal influenza. Residents of LCTFs should receive seasonal influenza vaccination and also should be vaccinated against 2009 H1N1 after assessment of vaccine availability at the local level indicates that demand for vaccine among younger age groups is being met. During October and November 2009, CDC received reports of several 2009 H1N1 flu outbreaks among residents and employees in long-term care facilities (LTCFs) in Colorado, Maine, and New York. These outbreaks show that, despite the lower risk of infection with 2009 H1N1 flu (compared with seasonal flu) among persons 65 years of age and older, 2009 H1N1 flu outbreaks can still occur in LTCFs. LTCFs should continue conducting respiratory illness surveillance and carrying out recommended infection control procedures. All health-care personnel should be vaccinated against 2009 H1N1 and seasonal influenza.